PMID- 21249528
OWN - NLM
STAT- MEDLINE
DCOM- 20110908
LR  - 20211020
IS  - 1556-0961 (Electronic)
IS  - 1541-6933 (Linking)
VI  - 14
IP  - 3
DP  - 2011 Jun
TI  - Surface cooling after cardiac arrest: effectiveness, skin safety, and adverse 
      events in routine clinical practice.
PG  - 382-8
LID - 10.1007/s12028-011-9506-y [doi]
AB  - BACKGROUND: Effectiveness of cooling and adverse events (AEs) involving skin have 
      not been intensively evaluated in cardiac arrest survivors treated with 
      therapeutic hypothermia (TH) when induced and maintained with a 
      servomechanism-regulated surface cooling system. METHODS: Retrospective review of 
      sixty-nine cardiac arrest survivor-events admitted from April 2006-September 2008 
      who underwent TH using the Medivance Arctic Sun Temperature Management System. A 
      TH database and medical records were reviewed, and nursing interviews conducted. 
      Primary endpoint was time from initiation to target temperature (TT; 32-34  degrees C). 
      Secondary endpoints were cooling rate, percentage of hypothermia maintenance 
      phase at TT, effect of body-mass index (BMI) on rate of cooling, and AEs. 
      RESULTS: Mean time to the target temperature (TT) was 2.78 h; 80% of patients 
      achieved TT within 4 h; all did within 8 h. Patients were at TT for 96.7% of 
      hypothermia maintenance; 17% of patients had >1 hourly temperature measurement 
      outside TT range. Mean cooling rate during induction phase was 1.1  degrees C/h, and was 
      not associated with BMI. Minor skin injury occurred in 14 (20%) patients; 4 (6%) 
      were device-related. Skin injuries were associated with shock (P = 0.04), and 
      decubitus ulcers were associated with left ventricular ejection fraction <45% (P 
      = 0.004). AEs included shivering (94%), hypokalemia (81%), hyperglycemia (57%), 
      pneumonia (23%), bleeding (22%), post-cooling fever (17%), and bacteremia (9%). 
      CONCLUSIONS: The Arctic Sun Temperature Management System was an effective means 
      of performing therapeutic hypothermia after cardiac arrest. Infrequent skin 
      injuries were associated with vasopressor use and low ejection fraction.
FAU - Jarrah, Salam
AU  - Jarrah S
AD  - Division of Pulmonary and Critical Care Medicine, Maine Medical Center, Portland, 
      ME, USA.
FAU - Dziodzio, John
AU  - Dziodzio J
FAU - Lord, Christine
AU  - Lord C
FAU - Fraser, Gilles L
AU  - Fraser GL
FAU - Lucas, Lee
AU  - Lucas L
FAU - Riker, Richard R
AU  - Riker RR
FAU - Seder, David B
AU  - Seder DB
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurocrit Care
JT  - Neurocritical care
JID - 101156086
SB  - IM
MH  - Aged
MH  - Body Mass Index
MH  - Equipment Design
MH  - Equipment Safety
MH  - Female
MH  - Heart Arrest/*therapy
MH  - Humans
MH  - Hypothermia, Induced/*adverse effects/*instrumentation/nursing
MH  - Male
MH  - Middle Aged
MH  - Pressure Ulcer/etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Skin/*injuries
MH  - Treatment Outcome
EDAT- 2011/01/21 06:00
MHDA- 2011/09/09 06:00
CRDT- 2011/01/21 06:00
PHST- 2011/01/21 06:00 [entrez]
PHST- 2011/01/21 06:00 [pubmed]
PHST- 2011/09/09 06:00 [medline]
AID - 10.1007/s12028-011-9506-y [doi]
PST - ppublish
SO  - Neurocrit Care. 2011 Jun;14(3):382-8. doi: 10.1007/s12028-011-9506-y.